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Donor versus no-donor comparison of newly diagnosed myeloma patients included in the HOVON-50 multiple myeloma study.
- Source :
-
Blood [Blood] 2012 Jun 28; Vol. 119 (26), pp. 6219-25; quiz 6399. Date of Electronic Publication: 2012 Mar 22. - Publication Year :
- 2012
-
Abstract
- To prospectively evaluate allogeneic stem cell transplantation (allo-SCT) for myeloma as part of first-line therapy, a donor versus no-donor analysis was performed of patients treated in the HOVON-50 study, a study that was originally designed to examine thalidomide combined with intensive therapy. Two hundred sixty patients having received an autologous-SCT fulfilled the criteria to be included, 138 patients without an HLA-identical sibling donor and 122 patients with a donor. After a median follow-up of 77 months, complete remission, progression-free survival (PFS), and overall survival were not significantly different between the 2 groups. PFS at 6 years was 28% for patients with a donor versus 22% for patients without a donor (P = .19) and overall survival at 6 years from high-dose melphalan was 55%, irrespective of having a donor (P = .68). Cumulative incidence of nonrelapse mortality at 6 years after autologous-SCT was 16% in the donor group versus 3% in the no-donor group (P < .001). However, PFS was significantly prolonged in the 99 patients who actually proceeded to allo-SCT compared with the 115 patients who continued maintenance or received a second high-dose melphalan, but the difference did not translate into a prolonged survival benefit. These results do not support a general application of allo-SCT in all myeloma patients as part of first-line therapy.
- Subjects :
- Adult
Aged
Algorithms
Female
Hematopoietic Stem Cell Transplantation adverse effects
Hematopoietic Stem Cell Transplantation statistics & numerical data
Histocompatibility Testing
Humans
Male
Middle Aged
Multiple Myeloma diagnosis
Multiple Myeloma immunology
Neoadjuvant Therapy
Netherlands
Siblings
Transplantation Conditioning methods
Transplantation, Homologous
Treatment Outcome
Hematopoietic Stem Cell Transplantation methods
Multiple Myeloma therapy
Tissue Donors
Subjects
Details
- Language :
- English
- ISSN :
- 1528-0020
- Volume :
- 119
- Issue :
- 26
- Database :
- MEDLINE
- Journal :
- Blood
- Publication Type :
- Academic Journal
- Accession number :
- 22442350
- Full Text :
- https://doi.org/10.1182/blood-2011-11-393801